Table 3.

Evidence for cotesting with HPV and cytology vs cytology alone

PATIENTS/POPULATION	Women aged 30–65
INTERVENTION	Screening with cotesting (cytology + HPV)
COMPARATOR	Screening with cytology alone at same interval
OUTCOME	MAIN RESULT	NUMBER OF STUDIES	QUALITY OF EVIDENCE	COMMENTS
CIN3+	Absolute increase in detection of CIN3+ ranging from 17–31% in first round of screening	339–41	High	High-quality RCTs from Europe—indirectness based on population
Cancer incidence	Absolute decrease in cancer detected at 2nd round of 0.03–0.05%	240,41	High	High-quality RCTs from Europe—indirectness based on population
Colposcopies	No direct evidence			Not reported in RCTs
PATIENTS/POPULATION	Women aged 30–65
INTERVENTION	Screening with cotesting with HPV and cytology every 5 years
COMPARATOR	Screening with cytology alone every 3 years
OUTCOME	MAIN RESULT	NUMBER OF STUDIES	QUALITY OF EVIDENCE	COMMENTS
Cancer deaths (lifetime risk per 1000 women)	Decrease from 1.6–1.7/1000 to 1.4/1000	1*	Moderate-low	Modeling study, results consistent in sensitivity analysis using different inputs for sensitivity/specificity. Results consistent with other models showing relationship between sensitivity, specificity, and test frequency
Cancer incidence (lifetime risk per 1000 women)	Decrease from 8.5–8.9/1000 to 7.4–7.7/1000	1*	Moderate-low	Modeling study, results consistent in sensitivity analysis using different inputs for sensitivity/specificity. Results consistent with other models showing relationship between sensitivity, specificity, and test frequency
Colposcopies (lifetime risk per 1000 women)	Decrease from 416–758/1000 to 323–573/1000	1*	Moderate-low	Modeling study, results consistent in sensitivity analysis using different inputs for sensitivity/specificity. Results consistent with other models showing relationship between sensitivity, specificity, and test frequency

^*Kulasingam, Shalini L. Personal correspondence. 2011 Nov.